International journal of cardiology
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Review Case Reports
How to face emergencies in heart failure patients with ventricular assist device.
Ventricular assist device (VAD) technology has rapidly evolved, and VADs are now seen as a reliable lifesaving option to support the failing heart in the short- and long-term: in some cases, VAD therapy represents a well-accepted treatment option for advanced heart failure that can obviate the need for heart transplantation. In the near future, more and more cardiologists will encounter VAD patients in their clinical practice and need to know how to handle the inherent risks associated with VAD use. ⋯ Here, we describe two emergency scenarios in VAD patients, two paradigmatic clinical in-hospital situations, in different settings. Following a brief overview of the role of cardiopulmonary resuscitation maneuvers in VAD patients, we propose a working algorithm that might help to ensure a timely and efficient response to acute demands in this setting.
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Meta Analysis Comparative Study
Coronary artery bypass grafting with minimal versus conventional extracorporeal circulation; an economic analysis.
This study aims to develop a methodological framework for the comparative economic evaluation between Minimal Extracorporeal Circulation (MECC) versus conventional Extracorporeal Circulation (CECC) in patients undergoing coronary artery bypass grafting (CABG) in different healthcare systems. Moreover, we evaluate the cost-effectiveness ratio of alternative comparators in the healthcare setting of Greece, Germany, the Netherlands and Switzerland. ⋯ Surgery with MECC may be dominant (lower cost and higher effectiveness) compared to CECC in coronary revascularization procedures and therefore it represents an attractive new option relative to conventional extracorporeal circulation for CABG.
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Inappropriate shocks resulting from atrial tachyarrhythmias are highly problematic for patients with an implantable cardioverter defibrillator (ICD). We aimed to determine the effectiveness of catheter ablation of atrial fibrillation (AF) in preventing inappropriate shocks due to rapid AF in patients diagnosed with Brugada syndrome (BS) who were implanted with an ICD. ⋯ AF ablation in BS patients may be reasonable to prevent inappropriate ICD shocks resulting from rapid AF. However, ventricular extrastimuli just after the ablation had better be avoided in them.